Mortality in Mental Disorders and Global Disease Burden Implications: A Systematic Review and Meta-analysis
TLDR
Estimates suggest that mental disorders rank among the most substantial causes of death worldwide, and efforts to quantify and address the global burden of illness need to better consider the role of mental disorders in preventable mortality.Abstract:
Importance Despite the potential importance of understanding excess mortality among people with mental disorders, no comprehensive meta-analyses have been conducted quantifying mortality across mental disorders. Objective To conduct a systematic review and meta-analysis of mortality among people with mental disorders and examine differences in mortality risks by type of death, diagnosis, and study characteristics. Data sources We searched EMBASE, MEDLINE, PsychINFO, and Web of Science from inception through May 7, 2014, including references of eligible articles. Our search strategy included terms for mental disorders (eg, mental disorders, serious mental illness, and severe mental illness), specific diagnoses (eg, schizophrenia, depression, anxiety, and bipolar disorder), and mortality. We also used Google Scholar to identify articles that cited eligible articles. Study selection English-language cohort studies that reported a mortality estimate of mental disorders compared with a general population or controls from the same study setting without mental illness were included. Two reviewers independently reviewed the titles, abstracts, and articles. Of 2481 studies identified, 203 articles met the eligibility criteria and represented 29 countries in 6 continents. Data extraction and synthesis One reviewer conducted a full abstraction of all data, and 2 reviewers verified accuracy. Main outcomes and measures Mortality estimates (eg, standardized mortality ratios, relative risks, hazard ratios, odds ratios, and years of potential life lost) comparing people with mental disorders and the general population or people without mental disorders. We used random-effects meta-analysis models to pool mortality ratios for all, natural, and unnatural causes of death. We also examined years of potential life lost and estimated the population attributable risk of mortality due to mental disorders. Results For all-cause mortality, the pooled relative risk of mortality among those with mental disorders (from 148 studies) was 2.22 (95% CI, 2.12-2.33). Of these, 135 studies revealed that mortality was significantly higher among people with mental disorders than among the comparison population. A total of 67.3% of deaths among people with mental disorders were due to natural causes, 17.5% to unnatural causes, and the remainder to other or unknown causes. The median years of potential life lost was 10 years (n = 24 studies). We estimate that 14.3% of deaths worldwide, or approximately 8 million deaths each year, are attributable to mental disorders. Conclusions and relevance These estimates suggest that mental disorders rank among the most substantial causes of death worldwide. Efforts to quantify and address the global burden of illness need to better consider the role of mental disorders in preventable mortality.read more
Citations
More filters
Journal ArticleDOI
Magnitude and sources of distress in mid-life adults with chronic medical illness: an exploratory mixed-methods analysis.
Elizabeth N. Madva,Federico Gomez-Bernal,Rachel A. Millstein,Christopher M. Celano,Elyse R. Park,Carol A. Mastromauro,Ariana M. Albanese,Eleanor E. Beale,Jeff C. Huffman +8 more
TL;DR: It is found that mid- life participants reported greater psychological distress (depression/anxiety) than non-mid-life participants, and qualitative analysis revealed several specific sources of stress significantly more common in mid-life adults.
Journal ArticleDOI
The Association between Autism Spectrum Disorder Symptoms in High-Functioning Male Adolescents and their Mothers’ Anxiety and Depression
TL;DR: In this paper, the authors assess the impact of their child's symptoms of autism spectrum disorder (ASD) upon parents' anxiety and depression, and find that the boys' restricted and repetitive behaviours had the strongest relationship with their mothers' anxiety, followed by communication difficulties.
Journal ArticleDOI
Homocysteine level, body mass index and clinical correlates in Chinese Han patients with schizophrenia.
Yuanyuan Huang,Kai Wu,Hehua Li,Jing Zhou,Dongsheng Xiong,Xia Huang,Jiahui Li,Ya Liu,Zhilin Pan,David T. Mitchell,Fengchun Wu,Xiang Yang Zhang,Xiang Yang Zhang +12 more
TL;DR: It is suggested that Hcy level may be associated with BMI in patients with schizophrenia, and patients with high BMI show more severe clinical symptoms and higher glucose and lipid levels.
Journal ArticleDOI
Phenomena complexes as targets of explanation in psychopathology: The relational analysis of phenomena approach:
Kristopher Nielsen,Tony Ward +1 more
TL;DR: The authors suggest that DSM syndromes and symptom network models are too large to handle large numbers of individuals and thus are unsuitable for explanation in psychopathology, and suggest that they should be replaced with a smaller scale model.
Journal ArticleDOI
Co-production of “nature walks for wellbeing” public health intervention for people with severe mental illness: use of theory and practical know-how
Gill Hubbard,Catharine Ward Thompson,Robert Locke,Dan Jenkins,Sarah-Anne Munoz,Hugo Cornelis van Woerden,Margaret Maxwell,Yaling Yang,Trish Gorely +8 more
TL;DR: A theoretically-informed, evidence-based nature walks programme in a timely and relatively low-cost manner relevant in an era of growing mental illness and funding austerity is developed.
References
More filters
Journal ArticleDOI
Measuring inconsistency in meta-analyses
TL;DR: A new quantity is developed, I 2, which the authors believe gives a better measure of the consistency between trials in a meta-analysis, which is susceptible to the number of trials included in the meta- analysis.
Journal ArticleDOI
Meta-Analysis in Clinical Trials*
TL;DR: This paper examines eight published reviews each reporting results from several related trials in order to evaluate the efficacy of a certain treatment for a specified medical condition and suggests a simple noniterative procedure for characterizing the distribution of treatment effects in a series of studies.
Journal ArticleDOI
Meta-analysis of observational studies in epidemiology - A proposal for reporting
Donna F. Stroup,Jesse A. Berlin,Sally C. Morton,Ingram Olkin,G. D. Williamson,Drummond Rennie,Drummond Rennie,David Moher,Betsy Jane Becker,Theresa Ann Sipe,Stephen B. Thacker +10 more
TL;DR: A checklist contains specifications for reporting of meta-analyses of observational studies in epidemiology, including background, search strategy, methods, results, discussion, and conclusion should improve the usefulness ofMeta-an analyses for authors, reviewers, editors, readers, and decision makers.
Book
Practical Meta-Analysis
Mark W. Lipsey,David B. Wilson +1 more
TL;DR: This paper presents a meta-analysis procedure called “Meta-Analysis Interpretation for Meta-Analysis Selecting, Computing and Coding the Effect Size Statistic and its applications to Data Management Analysis Issues and Strategies.
Related Papers (5)
Global burden of disease attributable to mental and substance use disorders: findings from the Global Burden of Disease Study 2010.
Harvey Whiteford,Harvey Whiteford,Louisa Degenhardt,Louisa Degenhardt,Juergen Rehm,Juergen Rehm,Amanda J Baxter,Amanda J Baxter,Alize J. Ferrari,Alize J. Ferrari,Holly E. Erskine,Holly E. Erskine,Fiona J Charlson,Fiona J Charlson,Rosana E. Norman,Rosana E. Norman,Abraham D. Flaxman,Nicole E. Johns,Roy Burstein,Christopher J L Murray,Theo Vos +20 more